Vaccines

Question 1

two methods of vaccinations? which method generally works better?

Answer 1

active: administration of antigen to host to induce formation of abs and cell-mediate immunity (vaccination)
passive: transfer of immunity to a host using preformed immunologic products (immunoglobulins)
ACTIVE generally better b/c provides long-term immunity to dz vaccinated for

Question 2

9 viral vaccinations?

Answer 2

varicella (live attenuated virus)
measles, mumps, rubella (live attenuated virus)
zoster (live attenuated virus)
polio (dead virus)
rabies (dead virus)
HAV (dead virus)
flu (live attenuated or dead virus)
HBV (recombinant protein)
HPV (recombinant protein)

Question 3

additional considerations: if immunosuppressed? w/asplenia? pending international travel? what chronic dzs would you consider vaccinating in?

Answer 3

if immunosuppressed avoid live vaccinations
with asplenia recommend h. flu, pneumococcal, meningococcal
international travel usu want to get HBV, HAV
with chronic liver dz, DM or if healthcare personnel consider vaccinating

Question 4

forms of flu vaccine?

Answer 4

trivalent inactivated flu vaccine (IM or ID, high dose)
live attenuated vaccine (intranasal, give to “healthy individual”)
quadrivalent (additional flu B protection)

Question 5

what flu vaccine is C/I in PG?

Answer 5

LAIV (nasal spray)

trivalent or quadrivalent vaccination recommended in PG

Question 6

SEs of flu vaccination?

Answer 6

local reactions, fever, malaise, allergic reactions, neurological reactions

Question 7

SEs of live attenuated flu vax?

Answer 7

runny nose, cough, nasal congestion, fever, h/a, muscle aches, wheezing, abd pn or occasional vomiting or diarrhea, tiredness, weakness

Question 8

HAV preexposure vaccination is recommended for what populations?

Answer 8

international travelers
men whom have sex with men
IV drug or illicit drug uers
children greater than 1 yo (2005 change)
persons w/chronic liver dz
persons whom anticipate close contact w/international adoptee during first 60 d after arrival from country w/high levels

Question 9

HAV prevention?

Answer 9

immune globulin
0.06 mg/kg IM IgG or vaccination
covers you for 3-5 mos

Question 10

how to prevent HBV?

Answer 10

routine vaccination given at birth, 1 mo, 6 mo
children 0-18 who did not get vaccinated as a newborn
adults, 3 doses: sexually active ppl, STD, MSM, IV drug users, healthcare workers, persons w/DM, ESRD, HIV, chronic liver dz, household contacts, international travels to countries w/high rates

Question 11

what vaccination is given to all newborns?

Answer 11

HBV- monovalent HBV vaccine before d/c

Question 12

if mom is (+) for HBsAg, recommendation for newborn?

Answer 12

HBV vaccination and HBIG at birth

Question 13

what can the HPV vaccination possibly prevent?

Answer 13

development of HPV-related CAs such as cervical CA, genital warts, some less common CAs

Question 14

what two HPV strains cause 70% of cervical CAs? what two HPV strains cause 90% of genital warts?

Answer 14

HPV 16 and 18- cervical CAs

HPV 6 and 11- genital warts

Question 15

common SEs of HPV vaccine?

Answer 15

pain and swelling at injection site
lightheadedness
fainting

Question 16

when is meningococcal vax recommended?

Answer 16

individuals in close proximity to one another such as a college dorm, members of the military
meant to prevent meningitis from meningococcus

Question 17

pneumococcal vaccine protects against what specific bug?

Answer 17

steptococcus pneumoniae
suggested for those over 65 yo
two available injections: prevnar given first, then pneumovax 8 wks-1 yr later